Sociodemographic factors and psychotropic medication use among Alzheimer’s dementia patients diagnosed with normal pressure hydrocephalus and mild cognitive impairment: Sex variation in a retrospective cohort analysis

Archives of Gerontology and Geriatrics Plus Pub Date : 2025-08-24 DOI:10.1016/j.aggp.2025.100202

Oluranti Omolara Babalola , Adebobola Imeh-Nathaniel , Emmanuel I Nathaniel , Samuel I Nathaniel , Richard L. Goodwin , Laurie Theriot Roley , Ohmar Win , Thomas I. Nathaniel

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Abstract

Objective

This study aimed to examine the relationship between sociodemographic factors, psychotropic medication, and Alzheimer’s Dementia (AD) in patients with a history of Normal Pressure Hydrocephalus (ADNPH) and Mild Cognitive Impairment (ADMCI) and how it varies by sex, using the Social Determinants of Health (SDH) model.

Method

The study analyzed 33,735 patients who presented with ADMCI (n = 33,064) or ADNPH (n = 671) between February 2016 and August 2021 at Prisma Health-Upstate. Multivariable logistic regression identified key factors associated with ADNPH and ADMCI, including age, race, and medication use.

Results

African Americans (OR = 0.388, 95 % CI: 0.277–0.542), individuals with a history of tobacco use (OR = 1.175, 95 % CI: 1.004–1.375), and those treated with buspirone (OR = 1.415, 95 % CI: 1.116–1.794) were associated with ADNPH, whereas treatment with risperidone (OR = 0.217, 95 % CI: 0.103–0.459) was linked to ADMCI. In sex-stratified analyses, males with ADNPH were more likely to report a history of tobacco use (OR = 1.818, 95 % CI: 1.370–2.411, p < 0.001) and treated with citalopram (OR = 2.102, 95 % CI: 1.561–2.831, p < 0.001). Males with ADMCI were more frequently African Americans (OR = 0.312, 95 % CI: 0.174–0.559, p < 0.001) and reported alcohol use (OR = 0.685, 95 % CI: 0.531–0.885, p = 0.004). Among females, ADNPH were associated with alcohol use (OR = 1.684, 95 % CI: 1.359–2.087, p < 0.001) and treated with aripiprazole (OR = 1.690, 95 % CI: 1.163–2.458, p = 0.006) or memantine (OR = 1.752, 95 % CI: 1.283–2.392, p < 0.001). Females with ADMCI were African Americans (OR = 0.470, 95 % CI: 0.311–0.710, p < 0.001) and treated with donepezil (OR = 0.552, 95 % CI: 0.399–0.765, p < 0.001) or risperidone (OR = 0.046, 95 % CI: 0.006–0.330, p = 0.002).

Conclusion

Our findings highlight the need for targeted interventions that address social factors, psychotropic medication access, and disparities in healthcare to improve outcomes for patients with NPH and MCI.

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诊断为正常压力脑积水和轻度认知障碍的阿尔茨海默氏痴呆患者的社会人口统计学因素和精神药物使用：回顾性队列分析中的性别差异

目的利用健康的社会决定因素（SDH）模型，探讨常压性脑积水（ADNPH）和轻度认知障碍（ADMCI）患者的社会人口学因素、精神药物与阿尔茨海默氏痴呆（AD）之间的关系及其性别差异。该研究分析了2016年2月至2021年8月期间在Prisma Health-Upstate就诊的33,735例ADMCI （n = 33,064）或ADNPH （n = 671）患者。多变量逻辑回归确定了与ADNPH和ADMCI相关的关键因素，包括年龄、种族和药物使用。结果非裔美国人（OR = 0.388, 95% CI: 0.276 ~ 0.542）、有烟草使用史（OR = 1.175, 95% CI: 1.004 ~ 1.375）和丁螺环酮组（OR = 1.415, 95% CI: 1.116 ~ 1.794）与ADNPH相关，而利培酮组（OR = 0.217, 95% CI: 0.103 ~ 0.459）与ADMCI相关。在性别分层分析中，患有ADNPH的男性更有可能报告吸烟史（OR = 1.818, 95% CI: 1.370-2.411, p < 0.001）和西酞普兰治疗史（OR = 2.102, 95% CI: 1.561-2.831, p < 0.001）。患有ADMCI的男性更多是非洲裔美国人（OR = 0.312, 95% CI: 0.174-0.559, p < 0.001）和报告饮酒（OR = 0.685, 95% CI: 0.531-0.885, p = 0.004）。在女性中，ADNPH与饮酒相关（OR = 1.684, 95% CI: 1.359-2.087, p < 0.001），并与阿立哌唑（OR = 1.690, 95% CI: 1.163-2.458, p = 0.006）或美金刚（OR = 1.752, 95% CI: 1.283-2.392, p < 0.001）治疗相关。患有ADMCI的女性为非洲裔美国人（OR = 0.470, 95% CI: 0.311-0.710, p < 0.001），接受多奈哌齐（OR = 0.552, 95% CI: 0.399-0.765, p < 0.001）或利培酮（OR = 0.046, 95% CI: 0.006-0.330, p = 0.002）治疗。结论：我们的研究结果强调需要针对社会因素、精神药物可及性和医疗保健差异进行有针对性的干预，以改善NPH和MCI患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Archives of Gerontology and Geriatrics Plus

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